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A case of cytomegalovirus esophagitis difficult to distinguish from Crohn’s disease exacerbation

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Abstract

Patients with Crohn’s disease are at higher risk of opportunistic infection, especially if treated with immunosuppressive therapy. Cytomegalovirus has been reported to cause ulcerated lesions mainly in the lower gastrointestinal tract of inflammatory bowel disease patients. We herein report a rare case of Crohn’s disease complicated with cytomegalovirus esophagitis, which was difficult to distinguish from exacerbation of Crohn’s disease. Diagnostic values of clinical course, blood tests, endoscopic and histological examinations are limited but the present case was therapeutically diagnosed by antiviral therapy in combination with histological evidence of cytomegalovirus.

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Acknowledgements

I would like to thank Ryo Karashima, MD. and Ken Nishimura MD., PhD. for useful discussion.

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Authors and Affiliations

  1. Department of Gastroenterology and Hepatology, Kitasato University Kitasato Institute Hospital, Tokyo, Japan

    Mika Misaki, Shintaro Sagami, Aya Hojo, Masaru Nakano & Taku Kobayashi

  2. Center for Advanced IBD Research and Treatment, Kitasato University Kitasato Institute Hospital, 5-9-1 Shirokane, Minato-Ku, Tokyo, 108-8642, Japan

    Shintaro Sagami, Yoko Yamana, Masa Maeda, Aya Hojo, Yusuke Miyatani, Masaru Nakano, Toshifumi Hibi & Taku Kobayashi

  3. Department of Pathology, Kitasato University Kitasato Institute Hospital, Tokyo, Japan

    Ichiro Maeda

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  1. Mika Misaki
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Correspondence to Taku Kobayashi.

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Conflict of interest

Yoko Yamana has served as an endowed chair of Abbvie GK, Activaid, Alfresa Pharma, JMDC, Gilead Sciences, Nippon Kayaku, Eli Lilly Japan, Mochida Pharmaceutical, Janssen Pharmaceutical, Pfizer, Takeda Pharmaceutical, Bristol-Myers Squibb, Google GK. Masa Maeda has served as an endowed chair of Abbvie GK, EA Pharma, Zeria Pharmaceutical, JIMRO, Kyorin Pharmaceutical, and Mochida Pharmaceutical. Yusuke Miyatani has served as a speaker of AbbVie; received research funding from Japan Foundation for Applied Enzymology; and as an endowed chair of AbbVie, JIMRO, Zeria Pharmaceutical, Kyorin Pharmaceutical, Mochida Pharmaceutical, Otsuka Holdings, and EA Pharma. Toshifumi Hibi has received lecture fees from, AbbVie, EA Pharma, Janssen, JIMRO, Mitsubishi Tanabe Pharma, Mochida Pharmaceutical, Pfizer, Sandoz, Takeda Pharmaceutical, Zeria, advisory/consultancy fees from AbbVie, Celltrion Healthcare, EA Pharma, Eli Lilly, Gilead Sciences, Janssen, Mitsubishi Tanabe Pharma, Nichi-Iko, Nippon Kayaku, Takeda Pharmaceutical, Zeria, and research grants from AbbVie, Activaid, Alfresa Pharma, Bristol-Myers Squibb, Ferring Pharmaceuticals, Eli Lilly, Gilead Sciences, JIMRO, JMDC Inc., Janssen, Kyorin Pharmaceutical, Miyarisan, Mochida Pharmaceutical, Nippon Kayaku, Pfizer. Taku Kobayashi has served as a speaker, a consultant or an advisory board member for AbbVie, Alfresa Pharma, Bristol Myers Squibb, Celltrion, Covidien, EA Pharma, Eiken chemical, Eli Lilly, Ferring Pharmaceuticals, Gilead Sciences, Janssen, JIMRO, Kissei, Kyorin Pharmaceutical, Mitsubishi Tanabe Pharma, Mochida Pharmaceutical, Nippon Kayaku, Pfizer, Sekisui Medical, Takeda Pharmaceutical, Zeria Pharmaceutical, and received research funding from AbbVie, Alfresa Pharma, EA Pharma, Kyorin Pharmaceutical, Mochida Pharmaceutical, Nippon Kayaku, Otsuka Holdings, Pfizer, Prometheus, Sekisui Medical, Zeria Pharmaceutical.

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All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2008(5).

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Informed consent was obtained from all patients to be included in the study.

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Misaki, M., Sagami, S., Yamana, Y. et al. A case of cytomegalovirus esophagitis difficult to distinguish from Crohn’s disease exacerbation. Clin J Gastroenterol (2024). https://doi.org/10.1007/s12328-024-01978-z

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